Significant Changes Made to Nursing Home Rating System

The government’s five-star rating system for nursing homes is being revised significantly, the federal government announced on Monday. According to the New York Times, the current program is reportedly flawed because it relies on self-reported data that goes unchecked. The five-year old system is used to evaluate the country’s more than 15,000 nursing homes. Even though it is considered the gold standard, the nursing homes themselves report on staffing levels and quality statistics, two major criteria used in the rating. Furthermore, the federal government typically does not audit these reports.

Several revisions will be made beginning in January to address these problems, officials said on Monday. The new system requires nursing homes to report their staffing levels on a quarterly basis; this information will be reported electronically and be double-checked using payroll data. Additionally, the government will launch a nationwide auditing program to ensure accuracy of quality measures rating, which is based on information collected about each patient. President Obama signed a bill into law that funds $11 million to setting up the electronic collection system.

The bill, which was passed in September, is called the Improving Medicare Post-Acute Care Transformation Act (IMPACT). The new law will also require hospices to be inspected a minimum of once every three years. There was no requirement prior to this, as many facilities went uninspected for years.

The rating system will now also consider the percentage of residents on antipsychotic drugs. Oftentimes, nursing home residents with dementia are given these medications unnecessarily as a form of sedation, NYT reports. Although this percentage is already required, it has not had an influence on a home’s rating until now.

Additionally, the new system will ultimately allow consumers to look at statistics such as staff turnover, federal officials said; this is a vital measure of quality. Data will be electronically reported next year, but will not be shown in the ratings until 2016.

Brian Lee is executive director of Families for Better Care, a nursing home watchdog group.“Nursing home quality hinges upon high staffing levels,” Lee said to NYT. “if we are able to get better information on staffing levels, the higher the quality is going to be in the long run.”

Because the old rating system depends so heavily on unverified and incomplete information, even homes with a document history of problems were receiving top ratings, NYT reported in August. Marilyn Tavenner, the administrator of the Centers for Medicare and Medicaid Services, which oversees the rating system, hopes that the new system will improve the quality of care for patients. “We are focused on using as many tools as are available to promote quality improvement and better outcomes for Medicare beneficiaries,” she told NYT.